Total shoulder arthoplasty

General Precautions:
– Restrict active IR for 12 weeks secondary to subscapularis repair
– Avoid excessive shoulder extension for 6 weeks
– External rotation: to neutral at 4 weeks, increase 10° per week with arm at side. Goal is 40° ER in neutral ABD at 6 weeks.

Week 0-2
– Patient to do home exercises – pendulums, elbow/wrist ROM, neck ROM, grip strengthening –
Patient to remain in sling for 2 weeks post-op

Week 2-6
– ROM goals:
              – Week 4: 120° flexion / 30° ER at side; ABD 75° without ER
– Begin PROM, and progress to AAROM and AROM within ROM guidelines above
– No resisted IR
– Grip strengthening
– Canes / pulleys OK when progressing from PROM – maintain ROM restrictions above
– Modalities per therapist discretion

Week 6-12
– Progress AAROM and AROM
o May begin active IR and shoulder extension without resistance
– May begin light isometrics into ER/FF/abd
– No resisted IR until 12 weeks
– No resisted shoulder extension or scapular retraction

Week 12+
– May progress isotonic strengthening as tolerated including CKC exercises
– Increase PROM to full – stretch to end-ranges if needed
– Continue strengthening for scapular stabilizers and with functional activities